DURHAM, N.H. --
New research at the University of New Hampshire aims to
make hospital operating rooms safer by opening the lines of communication between
computerized hospital beds and blood pressure monitors.

“We’re trying to get pieces of equipment that don’t normally
talk to each other to do so,” says John LaCourse, professor of electrical
and computer engineering at UNH. “We’re doing something that we
feel is going to save peoples’ lives.”

In modern operating rooms, major pieces of equipment like beds and monitors
are computerized, yet they lack the ability to share information with each
other. When a bed is raised or lowered, for instance, a patient’s blood
pressure fluctuates but the monitor, which is static, may give a faulty reading. “Can
we have some kind of control in this existing environment? Absolutely,” says
LaCourse, noting that operating room personnel can mentally calculate a more
accurate reading. “But we want double-fault controls because there are
peoples’ lives at stake. Our primary objective is to reduce the 98,000
annual death rate caused by medical errors.” LaCourse notes that miscommunication
between operating room instruments may be a cause of these errors.

LaCourse is principal investigator on the project, which is supported by a
grant from the New Hampshire Industrial Research Center to work in conjunction
with Bedford company IXXAT, Inc. and Massachusetts General Hospital in Boston,
where it is part of a larger initiative called Operating Room of the Future.
Two of LaCourse’s students, senior Jeff Ojala and master’s student
Jonathan Waters, are leading most elements of the investigation. The team is
looking to calibrate the invasive blood pressure monitor based on changes to
a patient’s elevation and angle as the surgical bed changes position.

The researchers are exploring the use of CANopen, a communications protocol
that uses a common hardware and software packages while maintaining the integrity
of the proprietary electronics of each element. It’s been used in the
automotive industry for many years, creating interfaces between the various
computerized elements of cars that are manufactured separately. CANopen is
growing in popularity and use as a medical device interoperability standard.
Recently, it was adopted as a standard for communicating control data between
CT scanners and contrast agent injectors for the purpose of optimizing CT images.

“The most challenging part of this project has been trying to get information
from the manufacturers, who are trying to protect their rights,” says
LaCourse, noting that the medical device environment is ultra-competitive.
In his lab, two medical beds from competing manufacturers sit side-by-side;
the researchers must carefully guard operating information that’s unique
to each of them. “We don’t want to infiltrate their privacy or
their patent privilege,” he says.

Ojala and Waters are now moving their research into what LaCourse calls “closing
the loop.” If they want the patient’s blood pressure to stay steady,
at say 140 over 90, can they program the bed to automatically rise and fall
to maintain that blood pressure? “We’re trying to see if we can
not only get the bed and the monitor to talk to each other but also control
each other,” says LaCourse.

Ultimately, LaCourse hopes to demonstrate that this “plug-and-play” technology
can be adopted by all electronic instruments in operating rooms: Beds and blood
pressure monitors as well as ventilation systems, ultrasound monitors, and
electrocardiogram monitors will have CANopen software installed by the manufacturers.
Doctors and medical personnel will simply push certain buttons for certain
procedures instead of manually or mentally calibrating the instruments to each
other as they now must do.

And as the aging population brings more computerized medical equipment into
homes and other less formal caregiving settings, such interoperability will
become even more crucial. “Doctors and other medical professionals don’t
have the time to help these instruments communicate with each other. They have
more important things to do,” says LaCourse.

The New Hampshire Industrial Research Center (NHIRC) supports short-term research
collaborations between companies and the engineers and scientists at the University
of New Hampshire, Dartmouth College and other academic institutions. Established
by the state legislature in 1991, the NHIRC has awarded more than $4 million.
State funds are matched 1:1 by company contributions of cash, staff time, equipment,
supplies or services. (www.nhirc.unh.edu).